There is a growing bipartisan consensus in Washington, D.C. to reconsider how the government enforces drug laws. One Iowa legislator and physician hopes to contribute her expertise.
For many years, Republicans have been hesitant to embrace harm reduction, the policymaking philosophy that emphasizes health and safety over criminalization. State Sen. Mariannette Miller-Meeks — who is seeking the GOP nomination in Iowa’s 2nd Congressional District — is a promising example of the changing landscape.
This month, Miller-Meeks and state Rep. Ann Meyer, R-Fort Dodge, were honored as legislators of the year by the Iowa Harm Reduction Coalition, recognized for their efforts to make substance abuse treatment more accessible for Medicaid patients, which makes the process more efficient for both patients and the state government.
Miller-Meeks is not a doctrinaire drug reformer or a radical libertarian like me. As a doctor, she takes a evidence-based approach to public policy questions, seeking input from a wide range of constituents and professionals.
“When it comes to harm reduction, there’s drug policy, there’s law enforcement policy, there’s criminal justice and there’s health policy,” Miller-Meeks told me in an phone interview last week. “I think we can all agree there are reforms in the criminal justice system that need to be made. Looking at low-level possession — should that be a criminal offense?”
One of the main goals of Iowa harm reductionists in recent years has been legal needle exchange programs, which offer clean supplies to people who use intravenous drugs and are proven to prevent the spread of infectious disease.
While at least one Iowa organization provides clean syringes to drug users, Iowa is among the minority of states where that is illegal. Bills to change that have made some progress in the Iowa Legislature, but haven’t been passed.
Here again, Miller-Meeks is open to the idea and is working to assemble experts on the subject.
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“We have a way to go but we will bring stakeholders together and look at needle and syringe exchange and how that ties in with law enforcement, and how it makes their jobs more difficult or less difficult,” Miller-Meeks said.
On another top harm reduction issue of the day, proposals to restrict e-cigarettes, Miller-Meeks recognizes the potential pitfalls of overregulation pushing people onto the black market.
“There’s good evidence to show people quit smoking. We know in this current climate, using e-cigarettes that are black market, or not the mainstream ones you see advertised, and using substances not intended has created a problem,” Miller-Meeks said.
If Miller-Meeks is elected to Congress next year, she will join a Republican caucus in Congress with a demonstrated interest in rethinking the criminal justice system. Last year, Congress passed and President Donald Trump signed the First Step Act, which aims to reduce the federal prison population.
At long last, there is bipartisan recognition that locking people up is not only expensive, but often incongruent with public safety. Perhaps Congress could use another common-sense leader on these issues.
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